PL Weight Loss Clinic

PL Weight Loss Clinic Lena R. Bruce, M.D. Pam Pixley-Moss RMA 6518 Memorial Dr. Texas City, TX 77591 Phone (409) 933-0870 Fax (409) 935-8494 Patient Information (Please Print Clearly) Date:________________________________________ Name:________________________________SS#:____________________________________ Address:_____________________________City/State:_________________ Zip:__________ Home Phone:___________________________Cell Phone:_____________________________ Employer: _______________________________Email (home):_________________________ Email (work):____________________________Pager:___________________________________ DOB:______________ Age:________________Male/Female Marital Status: _________ Insurance Provider:_____________________ID:#____________________Group:__________________ Insurance Member Services Phone Number:___________________________________________________ Though we do not take insurance, we may have to pre-authorize your medication after you leave and this information would be helpful to get your medication faster. Primary Care Physician: __________________________________Phone:_____________________________ Preferred Pharmacy: _________________________________Phone:____________ City:______________ Allergies:____________________________________________________________________ ______________________________________________________________________________ Medications:_______________________________________________________ __________________________________________________________________ How did you hear about our clinic?___________________________________ ADULT HEALTH HISTORY QUESTIONAIRE CONFIDENTIAL PAST ILLNESSES Please check any illnesses you have has ___ Asthma ___ Hay Fever ___ Emphysema ___ TB ___ Kidney Trouble ___ High Blood Pressure ___ Rheumatic fever ___ Diabetes ___ Stroke ___ Cancer ________ (type) ___Anemia ___Arthritis ___ Gout ___ Abnormal Pap Smear ___ Stomach Ulcer ___ Mental Illness ___ Seizures ___ Depressions ___ Back Trouble ___ Bowel Trouble ___ Thyroid disease ___ Glaucoma ___ Gallstones ___ Hepatitis ___ Liver Problems ___ Bleeding Problems ___ Skin Problems ___ Alcohol Problem ___ Drug Addiction ___ Hear Loss ___ Polyps of Bowel ___ Sexually Transmitted Disease ___ HIV Women Only Age of last menstrual period_________ # of times pregnant_________ # of living children ________ Date of last Pap Smear________ was it normal?__ Date of last physical:_________ Age when period stopped __________ Birth Control Method _____________ HOSPITALIZATIONS/SURGIES/ INJURIES Please list any hospitalizations, surgeries, &/or injuries you have had: ______________________ ______________________ ______________________ Family History ___ Other:____________ Please circle any diseases your parents, Grandparents, brothers, sister, aunts or uncles have Had: Diabetes Asthma Stroke Cancer Alcoholism Seizures Heart Attack High Blood Pressure, Other______________ ADULT HEALTH HISTORY QUESTIONAIRE PERSONAL HISTORY Name:_________________________ DOB:_______________________ Yes No Do you have any trouble reading # of years of high school completed___________ Do you have any special interest? Please list________________________ Do you have any personal concerns which are troubling you? If ―yes‖, please check those concerns: ____ Hospital bills ____ Social Security ____ Occupation ____ Transportation ____ Legal ____ Family ____ Marriage ____ Sex ____ Loneliness ____ Death ____ ____ ____ ____ ____ ____ ____ Housing/Rent/Heat ____ Other matters (food, clothing,etc) ____ Community Agencies (welfare,etc) ____ Emotional Problems/Nerves ____ Other: _______________________ Yes No ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ Would you like to talk with a counselor or social worker? Would you like to talk with a nutritionist? Do you get regular dental check-ups? Do you exercise at least 3 times a week? Do you limit sun exposure or use of sunscreens when tanning? Do you smoke cigarettes? Packs per day_______ Years_____ Do you smoke cigars? Do you use snuff or chewing tobacco? Do you drink alcohol (beer, wine or mixed drinks? # of drinks per day___________ Have you ever felt the need to cut down on your drinking? Have you ever been annoyed by criticism of your drinking? Have you ever had guilty feelings about your drinking? Do you ever drink a morning eye-opener? Do you smoke pot? ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ ___ ____ ____ ____ ___ ____ ____ ____ ADULT HEALTH HISTORY QUESTIONAIRE PERSONAL HISTORY The rest of these questions are for you to see if you might be at risk to get AIDS. You do not have to write down your answers, but if any answers are ―yes‖, you could be at risk for AIDS and should talk to your practitioner about it. Yes Have you had more than one sexual partner in the past year? Has your partner had sex with anyone other than you, since you have been partners? Have you or your sexual partners ever used IV drugs? Have any of your sexual partners ever had AIDS or a Positive HIV test? Please explain your goals and what diets you have tried: ____ ____ ____ ____ No ____ ____ ____ ____ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ What is your occupations and activity level? ________________________________________________________________________ ________________________________________________________________________ Please read this information packet to be informed of the possible side effects of the methods used to help you in your weight loss program. Discuss any concerns you have with Dr. Bruce before starting this clinic. By signing this form, you are stating that you have received this packet and are fully aware of the possible side effects and your consent to treat. You must notify Dr. Bruce or the nurse immediately if you experience any adverse reactions. Patient’s Signature ___________________________________ Date__________________________ For Appointments and Questions, please send an email through the website: www.plweightlossclinic.com Clinic Hours: Monday – Thursday 1:00 til 8:00pm. Any additional dates or times will be posted. We are also opened 2 Saturday mornings a month. Check website for times and dates. Fees: New Patient visit w/ shot (AMP/B12 or HCG/B12 or LIPO-B/B12) New Patient visit with shot (GH/B12) Single Shots(AMP/B12 --OR--HCG/B12—OR--LIPO B/B12) Combo shots( HCG/AMP/B12 OR AMP/Lipo/B12 ) GH w/B12 B12 shot (weekly) Any Follow/Up visit with Dr. Bruce includes shot and/or prescription HGH Spray Super Citrimax Chitosan MVI Extreme Trim Extra Strength Water Pill w/Potassium Slim Mist Sprays Thyroid Testing (immediate results) Sublingual B12 ` $100.00 $125.00 $25.00 $40.00 $40.00 $15.00 $55.00-$70.00 $60.00 $15.00 $15.00 $10.00 $15.00 $10.00 $25.00 $15.00 $10.00 ` IMPORTANT NOTICE: During Weight Loss Clinic hours, Dr. Bruce will only be able to see patients for weight loss issues and by appointment if possible. Any other unrelated issues to the program must be addressed with a medical appointment during her medical practice hours or with your regular physician. Sorry, we hope all understand in fairness of time to other patients. ATTENTION: The Weight Loss Clinic will only accept cash. An ATM machine is located in the Lobby of Mainland Center Hospital or at the Service station located at the corner of Hwy 3 and Texas Ave. Follow-Up Appointments: You MUST always remember to keep your Follow-Up appointments. If you can‘t make your follow up appointment, please send an email through the website (www.plweightlossclinic.com) or text/call us 409502-7845. This will allow us to schedule someone else in your place. Routinely missing follow-up appointments, will delay in getting your prescriptions refilled. Please email, text or call if you can not make your appt. prior to 24 hours of your appt. time- no show charge of $25.00 WILL APPLY. Name:_________________________________________ Date:__________________________________________ New Patient Questionnaire Have you ever been on a diet program before?_________________ If yes, with a doctor? ______ Who_______________________ What kind of program? ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ _________________________________ What kind of diet pills have you tried? ______________________________________________________________________________ ______________________________________________________________________________ ______________________ If you have been on a diet pill (s), which ones and did it work or not?__________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Did you have any side effects to the pills like jittery, headaches etc?________ Please list side effects: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Please explain in detail your experience and concerns about past dieting experiences. ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ What kind of activity do you do daily? Example: desk job or lots of walking with stairs etc? ______________________________________________________________________________ ______________________________________________________________________________ ____________________________________________________________________________ What are your goals for this program? ______________________________________________________________________________ ___________________________________________________________________________ Did You Know that Stress Can Cause Weight Gain? (Must be completed as part of the New Patient Package and/or for Follow/Up Visits) Name:______________________________ Age:______________ Date:_________________________ For each question below, circle the number to the right that best represents your answer. Base your answers off of your behavior for the last 6 months. S O M E T I M E S V E R O F T E N Description/Identification of Survey Item N E V E R R A R E L Y O F T E N 1. How often do you make careless mistakes when you work on boring or difficult projects? 2. How often do you have difficulty keeping your attention when you are doing boring or repetitive work? 3. How often do you have difficult concentrating on what people say to you, even when they are speaking to you directly? 4. How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done? 5. How often do you have difficulty getting things in order when you have to do a task that requires organization? 6. When you have a task that requires a lot of thought, how often do you avoid or delay getting started? 7. How often do you misplace or have difficulty finding things at home or at work? 8. How often are you distracted by activity or noise around you? 9. How often do you have problems remembering appointments or obligations? 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 1 1 1 2 2 2 2 2 2 2 2 2 3 3 3 3 3 3 3 3 3 4 4 4 4 4 4 4 4 4 PART A TOTAL:____________________________ 10. How often do you fidget or squirm with your hands or feet when you have to sit down for a long time? 11. How often do you leave your seat in meetings or other situations in which you are expected to remain seated? 12. How often do you feel restless or fidgety? 13. How often do you have difficulty unwinding and relaxing when you have time to yourself? 14. How often do you feel overly active and compelled to do things, like you were driven by a motor? 15. How often do you find yourself talking too much when you are in social situations? 16. When you are in a conversation, how often do you find yourself finishing sentences of the people you are talking to, before they can finish it themselves? 17. How often do you have difficulty waiting your turn in situations when turn taking is required? 18. How often do you interrupt others when they are busy? 0 0 0 0 0 0 1 1 1 1 1 1 2 2 2 2 2 2 3 3 3 3 3 3 4 4 4 4 4 4 0 0 0 1 1 1 2 2 2 3 3 3 4 4 4 Part B Total:________________________________ Could Your Lack of a Good Night Sleep be Causing Your Weight Gain? (Must be completed as part of the New Patient Package and/or Follow Up visits) Name:___________________ Date:_________________ Epworth Sleepiness Scale Evaluation Use the following scale to assign the most appropriate number for each situation listed. A score of 10+ indicates you should have a sleep study to address your healthcare needs. If you score 10 or more, please consult your physician. 0 = No chance of dozing 1 = Slight chance of dozing 2 = Moderate chance of dozing 3 = High chance of dozing 1 2 3 4 5 6 7 8 Situation Sitting and reading Watching TV Sitting, inactive in a public place (i.e. theater, meeting) As a passenger in car for an hour without a break Lying down to rest in the afternoon if circumstances permit Sitting and talking with someone Sitting quietly after lunch without alcohol In a car, while stopped for a few minutes in traffic Circle One 0 1 2 0 1 2 0 1 2 0 0 0 0 0 1 1 1 1 1 2 2 2 2 2 3 3 3 3 3 3 3 3 TOTAL SCORE________________ 7 or less = You have a normal amount of sleepiness 8 to 9 = You have a average amount of sleepiness 10 to 15 = You may be excessively sleepy depending on the situation and you may want to seek medical attention. 16 + up = You are excessively sleepy and should seek medical attention Sleep Diagnostics of America 281-218-6990 NOTES OR QUESTIONS YOU WOULD LIKE TO ASK WHEN YOU SEE THE DOCTOR AT THE TIME OF YOUR VISIT. What did you eat yesterday to give us an idea of your eating habit. After Pam‘s presentation of the combination diet so we can see if you understand, answer the next question: What will you tomorrow? Visit Us At Our Website: www.plweightlossclinic.com PLEASE HAND IN THIS COMPLETED PACKET TO THE FRONT DESK SO YOU CAN BEGIN THE REST OF YOUR LIFE… The rest of this package is yours to keep. Lena R. Bruce, M.D. Drug Therapy for Obesity These are just a few of the different medications Dr. Bruce uses. After reviewing your health history and speaking with you one on one she will discuss these and other options to customize a program for you. Phenylpropanolamine (Dexatrim) is an over the counter appetite suppressant and decongestant. The most common side effects include nervousness, insomnia, dizziness, palpitations and headaches. Patients being treated for high blood pressure, depression, anxiety disorder, or if they have diabetes, heart disease, or thyroid disease must consult with physician. Phentermine (Ionamine) along with Fastin and Adiphex is a short term adjunct in a regimen of weight reduction based on calorie restriction. The most common side effects include headaches, insomnia, nervousness and irritability. Palpitations, tachycardia, and elevated blood pressure may also occur. These types of medications must not be taken by persons with hyperthyroidism, glaucoma, agitated states, advanced arteriosclerosis, symptomatic cardiovascular disease, and moderate to severe hypertension or a history of drug abuse. Fluoxetine (Prozac) may increase energy expenditure by raising basal body temperature; however, weight loss has not been consistent among subjects in clinical trials. (SSI) Meridia is used to suppress appetite in a fashion similar to SSI‘s. Sibutramine may also stimulate thermogenesis. The most common adverse effects associated with the use of Meridia are dry mouth, anorexia, constipation and insomnia. The combination of ephedrine and caffeine possesses anorectic and thermogenic properties. Some of the side effects are tremors, insomnia and dizziness after eight weeks of treatment. DIGESTIVE INHIBITORS Orlistat (Xenical) and ALLI prevents the absorption of about 30 percent of the dietary fat. Gastrointestinal side effects are flatus with discharge, oily spotting and oily stool, fecal urgency, fecal incontinence and abdominal pain. Fat Substitutes Olestra (Olean) side effects are bloating, flatulence, diarrhea, loose stools and anal leakage. Slendermist® (Chocolate Fudge, Tropical Delite, Arctic Mint, Berry Supreme) If you‘re trying to lose weight, you know it isn‘t easy! Maybe you have tried dozens of diets or other weight control programs, yet the extra pounds remain or quickly come back. Now, exclusively from Karemor comes Slendermist®. It is a convenient, all natural formula designed to quickly satisfy without overeating and drugs. Just a quick spray and the natural ingredients of Slendermist go to work immediately. These carefully formulated nutrients help you to maintain a more balanced diet during regularly scheduled meals. What‘s more, Slendermist® tastes terrific! Slendermist® Dietary Snack spray is available in four mouthwatering flavors. Why is this important? Many scientific studies from major universities have documented the existence of the brains taste set point. If this is not satisfied, most weight loss will be short-lived. But Slendermist isn‘t just great tasting, it is a unique formulation of extra vitamins and amino acids. Fiber is very important in our diet. We as a society eat too much fatty/fried/fast foods that lack high fiber. You need fiber for good colon and digestive care. If you are not evacuating your colon daily you are already slowing down your metabolism. We do not care what fiber you use—benifiber, fiberone or our CHITOSAN-just use it and drink lots of water with it. If you suffer from IBS or constipation already, you might consider a series of colon therapy-Internal Cleansing Detoxify. We suggest Dr. Erika Le Beau 832-264-8334. Chitosan is a dietary supplement made from the shells of crabs, shrimp, and lobsters. Some people experience stomach upset with chitosan. Since chitosan is made from shellfish, people with shellfish allergies should check with a physician before taking this supplement. Citrimax (Herbal) FOR SUGAR CRAVINGS This optimized Citrimax includes ChrorneMate® chromium to supped healthy blood sugar levels, ginseng for energy, and kelp to promote healthy metabolism. This highly bioavailable Citrimax formula is made by a patent-pending manufacturing process using exclusively dried fruit rind of Garcinia cambogia (Gc), a high quality raw material that contains about 20% HCA (hydroxycitric acid), a natural compound that promotes weight management. Promote Natural Appetite Control The amazing beneficial properties of Citrimax have been the subject of extensive scientific research reported on over 100 television news programs. Although a relatively recent discovery of the Western world, Garcinia cambogia — the key ingredient in Citrimax, has been harvested and used for centuries by the people of India as an aid to making meals more ‗filling.‘ As part of a complete diet plan, Citrimax may help you maintain a healthy appetite. Chromium supports healthy blood sugar levels, thereby potentially reducing the tendency to snack between meals. Chrome Mate® Chromium Chromium supplements vary widely in potency. Inorganic chromium chloride, the most common chromium supplement, is absorbed less than 2%. Chrome Mate®, however, consists of pure niacinbound chromium, the biologically active form that strongly potentiates action. In this way, Chrome Mate® promotes healthy insulin function and increased energy. For best results, combine Citrimax with your overall weight management program that includes a healthy diet and exercise. Exercise is very important. Make everything you do an exercise. Sweeping your house, holding your stomach in for 20 secs and release then repeat while you are sitting at your desk or car. Park further away and walk, maybe add ankle weights. Or just wake up 30 minutes earlier and walk around the block—JUST DO IT. Use this time while you are on this program getting shots, pills and support, to change your lifestyle so you can be slimmer and healthy for the rest of your life. It takes two weeks to break a bad habit and two to make a new one. Our Injection 1. Adenosine Monophosphate AMP is a high concentration of amino acids that helps decrease your appetite and increase your metabolism. Also help with increase energy level. The AMP and the Hcg or Lipo-B injections can be give together and is called Combo Shot or can be given separately but alternating per week. This will discussed at your evaluation with the doctor. They have to given one at a time each week then if you choice you can do combos. 2. Human growth hormone-HcG is produced in the pituitary gland is secreted throughout a person‘s Life It promotes growth in children and plays an important role in adult metabolism. It was first isolated in 1956 and its Structure was identified in 1972. Until the mid-1980s the only source of hcg. – was from pituitary glands collected post mortem. Today hcg is available in larger quantities through the technique of genetic engineering and a number of conditions apart from the classical growth hormone Insufficiency can be treated. Human growth hormone is the master hormone produced by the master the pituitary which rests Just behind our eyes. Hcg. – acts as a catalyst for many glandular secretions and life functions critical to maintaining youth. It‘s the stuff that makes nearly every cell in our bodies grow and repair over the course of our lives. We‘ve done the research and found the best hcg. Side effects choices from all over the web for you. We have reviewed many different hcg. Products and decided to recommend a few hcg side effects sites. The Hcg Formula is the most advanced hcg side effects system available anywhere on the internet. Some women experience tender breast and heavier menstrual cycle, about 1 out of 25. According to Dr. Rona Klatz and Dr. Robert Goldman of the American Academy of Anti-Aging Medicine, HON can ―reduce body fat by 14.4 percent after six months, without dieting. Increased Muscle Mass – Dr. Klatz and Dr. Goldman as stating HCG causes ‗an average gain of 8.8 percent in muscle mass after six months, without exercise‖ Better body contour – HCG may be the most effective fat-loss regimen ever discovered. Raised levels of HCG can re-contour the body, melting away fat and building muscle, in two studies performed by Dr. David Clemmons, chief of endocrinology at the University of North Carolina in Chapel Hill, elevated FISH levels combined with dieting caused a 25% acceleration in the rate of fat loss, above and beyond the effect of dieting alone. In 11 weeks, the subjects lost between 20 to 32 pounds of fat while maintaining theft body tone. Another fact worth mentioned about HCG is that it contains no hormones. Instead it has stimulatory effect for the pituitary gland in order to produce more natural human growth hormone. Thus, HCG is a safe and healthy to use supplement. 3. Lipo B- The Fat Burning Shot Frequently Asked Questions: What are Lipo B (vitamin B12 with Lipotropics) Weight Loss Injections? Lipotropics are three amino acids that are essential for the health of your liver. The liver is an organ responsible for removing fat and toxins from your body, so when it's healthier, it will work better for you. Vitamin B12 gives you a huge energy boost, which helps you to burn calories. The vitamin cocktail included in the B12 and Lipotropic shots are compounds that enhance liver function and increase the flow of fats and bile from the liver and gallbladder. By definition, a lipotropic substance decreases the deposit, or speeds up the removal of fat within the liver. The key amino acids used to make these shots are Vitamin B12, Choline, Methione, and Inositol. fatigue and may be useful in some cases of allergy because it reduces histamine release. Inositol, a nutrient belonging to the B vitamin complex, is closely associated with choline. It aids in the metabolism of fats and helps reduce blood cholesterol. Inositol participates in the action of serotonin, a neurotransmitter known to control mood and appetite. 4. What about B12 injections by themself? We offer B12 by itself because some people just want the energy, not the weight loss, and others who want to lose weight but have a sulfa allergy can take this and at least boost their energy so they burn more calories. The results are slower with the B12 by itself, but it does help. Vitamin B12 is a vitamin typically found in meat and dairy products. It helps in the formation of red blood cells and is essential for nervous system functioning. B12 creates a significant energy boost for the body. Patients who take it feel like moving around more and tend to burn more calories through increased movement. 5.. GH-True Growth Hormone (TevTropin): This is true growth hormones. GH is use to increase muscle tone, increase metabolism and decrease appetite when a patient hits a plateau. This injection is like the Hcg but stronger. This injection is also used when a patient is very success in working out and gain muscle mass. This will be discussed in at depth your visit with Dr. Bruce. HGH Spray: This is Human growth hormone in a spray form. If a patient travels a lot or is unable to get the injections weekly, HGH spray is an alterative. Just spray 5 sprays in mouth a couple times a day. One bottle should last one month. You can not donor blood if you use this product For Appointments and Questions, please send an email through our website: www.plweightlossclinic.com Clinic Hours: Monday – Thursday 1:00 til 8:00pm. Any additional date or times will be posted. We are open 2 Saturday mornings per month. Check website for times and dates. Fees: New Patient visit w/shot(AMP/B12or Hcg/B12or Lipo/B12) $100.00 New Patient visit with shot (GH/B12) $125.00 Single Shots (AMP/B12 or Hcg/B12 or Lipo/B12) $25.00 Combo shots HCG/AMP/B12 or AMP/Lipo/B12 $40.00 GH w/B12 $40.00 B12 shot (weekly) $15.00 Any visit w/ Dr. Bruce depending on shot and/or prescription $55.00-$70.00 HGH Spray $60.00 Super Citrimax $15.00 Chitosan $15.00 MVI $10.00 Extreme Trim $15.00 Extra Strength Water Pill w/Potassium $10.00 Slim Mist Sprays $25.00 Thyroid Testing (immediate results) $15.00 Sublingual B12 $10.00 IMPORTANT NOTICE: During Weight Loss Clinic hours, Dr. Bruce will only be able to see patients for weight loss issues and by appointment if possible. Any other unrelated issues to the program must be addressed with a medical appointment during her medical practice hours or with your regular physician. Sorry, we hope all understand in fairness of time to other patients. ATTENTION: The Weight Loss Clinic will only accept cash. An ATM machine is located in the Lobby of Mainland Center Hospital or at the Service station located at the corner of Hwy 3 and Texas Ave. We apologize if this causes anyone any inconvience. Follow-Up Appointments: Also, always remember to keep your Follow-Up appointments. If you can‘t make your follow up appointment, please send an email through the website (www.plweightlossclinic.com) This will allow us to schedule someone else in your place. Patients who miss two (2) followup appointments, will be delayed in getting your prescriptions refilled. Not calling, emailing or texting us prior to 24 hours of your scheduled appt. there will be charge of $25.00. Dear Weight loss Client, Just a few friendly reminders and procedure changes. We try to see clients as quickly as we can. We are asking the clients to help to shorten the long wait time by understanding a few new changes. Due to the high volume of clients; Pam will be doing weight and shots on the weekly visits. Complete measurements will be done once a month. This should speed up the flow on evening clinic. As for the follow up visits with Dr. Bruce, we are asking for your help in speeding up that process by restricting your concerns to the program which should take no longer than 10-15 minutes and not other unrelated issues. This limitation on the visit is to be fair to all who are waiting to see the doctor. If you are on Adderall,Ritalin and Vynase (which requires a hand written special prescription from the doctorAND MUST BE FILLED WITHIN 21 DAYS STATE LAW) and know you need this special type prescription for that medication every month, please make your appointment each month for the following month before you leave. Not doing so causes delays in the schedule for the patients who do have appointment and Dr. Bruce. On the subject of follow up visit, it is very important to keep your appointment with the doctor, not doing will cause a delay in your medication refills. If you need to reschedule your follow up, please do as soon as possible, there is a waiting list. Not calling may result in a no show charge. Sometimes Dr. Bruce prescribes a medication that your insurance plan requires Pam to call and preauthorize. This is just for medication, not coverage for program itself. This is a process where Pam calls your prescription plan company ( Medco, Advance Rx, Express Scripts etc) to answer questions to why you need this medication. Your insurance decides coverage or not based on that information. Pam tries to do this within 24 hours of notification from the pharmacy. This is happening more and more. We do suggest that you call different pharmacies for pricing of your medications with and without your insurance; you may be surprised on the vast difference in pricing. Pam‘s progressing of this would be made easier if we had a copy of your prescription card with your Id or member number and company phone number on it. Sometimes this information is on the back of your medical insurance card. As you come in for your next visit, will you please give the front desk person a copy of your driver‘s license and the above mention card. Preferably if you can have the copy already copied before you come, because we all know how busy the front gets between 5:15 and 6:30pm. Thank you for your cooperation and understanding in the above matters. Remember to get a schedule of the hours every month. Thank, Dr. Bruce and Pam COMBINATION DIET STARCHES Rice, breads, pasta, cakes, potatoes chips, French fries, corn, baked potatoes, brownies, cereals, pizza dough, pastries, flour tortillas, crackers, donuts, cupcakes, dumpling, bagels, buns, wheat bread, pretzels, biscuits, pancakes, taco shells, bran muffins, bread sticks, blueberry muffins, cornbread, pita bread, waffles, French bread, hotdog buns, pie crust, croutons, noodles, chocolate cake, baked potatoes, potato salad, oatmeal, granola, cream of wheat, grits. PROTEINS NO Chicken,fish,steak,pork,beef,fatjitas,cheese,eggs,milk, cream,lamb,whipped cream, nuts, seeds, beans, lunch meats, bacon, hamburgers ,hot dogs, boloney, liverworts, shrimp, crab, ham, salami, sausage, scallops, Yogurt, tofu, cream cheese, American cheese, provolone cheese, chili, turkey, tuna, pastrami, goose, mussels, pepperoni, corned beef, meatballs, beef brisket, veal, quall, pheasant, Canadian bacon, Italian sausage, sardines, anchovies, pinto beans, fish. SIMPLE MEALS SAVE ENERGY YES ↕ VEGETABLES ↕YES NO NO Carrots, lettuce, cabbage, peppers, beets, string beans, cucumbers, celery ,eggplant ,garlic, Brussels sprouts, kale, spinach, collard greens, mushrooms, cauliflower, asparagus, tomatoes, avocados, bok choy, swiss chord ,mustard greens, peas, zucchini, broccoli, leeks, parsley ↕NO↕ Try frozen fruit with juice and or artificial sweetener in a blender. FRUITS Apples, bananas, pears, oranges, grapefruit, blueberries, cherries, apricots, Grapes, lemons, limes, peaches, plums, strawberries, tangerines, pineapple, watermelons, cantaloupes, nectarines, raspberries, mangos, papaya. FRUIT RULE: FRUIT ALONE OR LEAVE IT ALONE. FRUIT ALL MORNING LONG AND YOU CAN’T GO WRONG. Remember Corn, peas and potatoes are starchy and can not be eaten with PROTEIN . *Vegetables are best eaten raw to preserve vitamins and mineral content. >Live foods=Live Bacteria Tomatoes combined well with non-starchy vegetables and proteins. i.e. raw nut butter on sprout grain bread with lettuce and tomatoes-simply delicious!! IMPROPER COMBINATIONS BLT sandwich Milk & Donuts Cheese pizza Hamburger & bun Tuna sandwich Egg muffin Breaded veal Spaghetti w/meat Steak & Potato Hotdog & bun Turkey Sandwich pancake & eggs egg rolls cereal w/milk peanut butter/jelly sandwich bean burritos PROPER COMBINATIONS Steak and vegetables Potatoes and vegetables French fries/salad potato lasagna fish and vegetables vegetable pizza mixed vegetable salad eggs and bacon/sausage vegetable burritos pancakes/butter/syrup Baked eggplant Dumplings/olive oil/salad Pasta/olive oil salad/bread Stir fry vegetables/rice Pork and vegetable DIGESTION TIMES Fresh fruit juice= 0 minutes Fresh fruit smoothies= 15 minutes Fresh vegetable juice= 10 minutes Whole fresh fruit= 20 minutes Salad & Raw vegetables = 2 hours Properly combined Meal (no Flesh)( Starch and veg) = 3 hours Properly combined Meals with flesh(Protein and veg) = 4 hours Improper combined Meals( Starch and Protein)= 8 hours Improperly combined Meals followed with fruit= 40 hours EXAMPLES OF COMBINATION DIET (LIFESTYLE CHANGES) I HOP: PROTIEN MEAL JUICE BEFORE YOUR MEAL COMES TO THE TABLE—BUT STOP WHEN FOOD COMES TO TABLE –REMEMBER FRUIT IN ANY FORM ALONE. BACON, EGGS, VEGATABLES (SLICED TOMATOES,MUSHROOMS,ONION ETC) MILK OR COFFEE I HOP: STARCH MEAL JUICE BEFORE YOUR MEAL COMES TO TABLE—BUT STOP WHEN FOOD COMES TO TABLE –REMEMBER FRUIT IN ANY FORM ALONE. PANCAKES WITH SYRUP, GRITS, TOAST, WAFFLES , CREAM OF WHEAT OR OATMEAL COFFEE OR TEA --- NO MILK I-HOP: FRUIT PLATE RYAN’S STEAK HOUSE PROTEIN MEAL: STEAK (OR ANY PROTEIN) WITH ANY NON STARCH VEGETABLES. REMEMBER NO CORN, PEAS OR POTOTES. OR STARCH MEAL: PASTA WITH ANY VEGETABLES. _____________________________________________________________________ OLIVE GARDEN: STARCH MEAL: BREAD STICKS, SALAD (NO CHEESE) HOUSE DRESSING, PASTA WITH MARINARA SAUCE REMEMBER IF YOU START A MEAL WITH CHIPS OR BREAD YOU HAVE COMMITTED YOUR SELF TO A STARCH MEAL. SO IF YOU INTEND TO EAT PROTEIN SAY NO TO THE BREAD AND CHIPS. DON’T BE AFRAID TO ASK FOR SUBSTITUTES. TIP: IF YOU INTEND TO GO TO THE MOVIES AFTER DINNER; EAT YOUR STARCH MEAL LIKE THE EXAMPLE AT OLIVE GARDEN SO YOU CAN HAVE THE POPCORN. YOU CAN HAVE IT DURING THE 3 HOUR DIGESTIVE TIMING OF THE STARCH MEAL BUT YOUR 3 HOURS STARTS ALL OVER AGAIN. THE SAME SCENARIO GOES WITH PROTIEN—IF YOU HAD A PROTIEN MEAL YOU CAN HAVE A PROTIEN SNACK DURING THE 4 HOUR DIGESTIVE TIMING BUT THE 4 HOURS STARTS ALL OVER AGAIN. UNDERSTANDING HOW AND WHY THE COMBINATION LIFESTYLE CHANGE WORKS…….. Protein and Starch "This is the worst possible combination of foods to mix together at a single meal, and yet it is the mainstay of modern Western diets: meat and potatoes, hamburgers and fries, eggs and toast, etc. When one consumes protein and starch together, the alkaline enzyme ptyalin pours into the food as it's chewed in the mouth. When the masticated food reaches the stomach, digestion of starch by alkaline enzymes continues unabated, thereby preventing the digestion of protein by pepsin and other acid secretions. The ever-present bacteria in the stomach are thus permitted to attach the protein and putrefaction commences, rendering nutrients in the protein food largely useless to you and producing toxic wastes and foul gases, including such poisons as indol, skatol, phenol, hydrogen sulphide, phenylpropionic acid, and others. If that is the case, you may well wonder, then why does the stomach have no trouble handling foods that naturally contain both protein and starch, such as whole grains? As Dr. Shelton points out, "There is a great difference between the digestion of a food, however complex its composition, and the digestion of a mixture of different foods." To a single article of food that is a starch-protein combination, the body can easily adjust its juices, both as to strength and timing, to the digestive requirements of the food. But when two foods are eaten with different, even opposite, digestive needs, this precise adjustment of juices to requirements becomes impossible." Source: Daniel Reid. Protein and Protein "Different proteins have different digestive requirements. For example the strongest enzymatic action on milk occurs during the last hour of digestion, whereas on meat it occurs during the first hour and on eggs somewhere in between. It is instructive to recall the ancient dietary law which Moses imposed on his people [the Jewish people], forbidding the simultaneous consumption of milk and flesh. Two similar meats such as beef and lamb, or two types of fish such as salmon and shrimp, are not sufficiently different in nature to cause digestive conflict in the stomach and may be consumed together." Source: Daniel Reid. Acid and starch "Any acid taken together with starch suspends secretion of ptyalin, a biochemical fact of life upon which all physicians agree. Therefore, if you consume oranges, lemons and other acid fruits, or acids such as vinegar's, along with starch, no ptyalin is secreted in the mouth to initiate the first stage of digestion. Consequently, the starch hits the stomach without the vital alkaline juices it needs to digest properly, permitting bacteria to ferment it instead. A single teaspoon of vinegar, or its equivalent in other acids, is all it takes entirely to suspend salivary digestion of starch in the mouth." Source: Daniel Reid. Acid and protein "Since protein requires an acid medium for proper digestion, you'd think that acid foods would facilitate protein digestion, but that's not the case. When acid foods enter the stomach they inhibit the secretion of hydrochloric acid, and the protein-digesting enzyme pepsin can work only in the presence of hydrochloric acid, not just any acid. Therefore orange juice inhibits the proper digestion of eggs, and a strong vinegar dressing on salads inhibits the digestion of steak." Source: Daniel Reid. Starch and sugar "It has been established that, when sugar enters the mouth along with starch, the saliva secreted during mastication contains no ptyalin, thereby sabotaging starch digestion before it reaches the stomach. Furthermore, such a combination blocks passage of sugar through the stomach until the starch is digested, causing it to ferment. The by-products of sugar fermentation are acidic, which in turn further inhibits digestion of starches, which require alkaline mediums for digestion. Bread (starch) and butter (fat) is a perfectly compatible combination, but when you spread a spoonful of honey or jam over it, you introduce sugars to the blend, which interferes with the digestion of the starch in bread. The same principle applies to breakfast cereal sprinkled with sugar, heavily frosted cakes, sweet pies, and so forth." Source: Daniel Reid. Melon "Melons are such a perfect food for humans that they require no digestion whatsoever in the stomach. Instead, they pass quickly through the stomach and move into the small intestine for digestion and assimilation. But this can happen only when the stomach is empty and melons are eaten alone, or in combination only with other fresh raw fruits. When consumed with or after other foods that require complex digestion in the stomach, melons cannot pass into the small intestine until the digestion of other foods in the stomach is complete. So they sit and stagnate instead, quickly fermenting and causing all sorts of gastric distress." Source: Daniel Reid. Desserts "One should avoid any sort of sweet dessert after a big meal, for this type of food combines poorly with everything. Even fresh fruit should be avoided right after a big meal because it will back up in the stomach and ferment instead of digest. If you really have a 'sweet tooth' and crave cakes, pies and pastries, indulge your habit occasionally by making a whole meal of them. They are still not good for you but at least taken alone they will not cause as much gastric distress and toxic byproducts as when taken after meals." Source: Daniel Reid. Trophology summary "Correctly combining foods makes all the difference in the world to proper digestion and metabolism. Without complete digestion, the nutrients in even the most wholesome food cannot be fully extracted and assimilated by the body. Moreover, incomplete digestion and inefficient metabolism are the prime causes of fat and cholesterol accumulation in the body. A low calorie diet of overcooked, processed and improperly combined foods will still make you fat and leave sticky deposits in your arteries, just as the wrong mix of fuels will leave carbon deposits on the spark plugs of an engine, clog the pistons, and create foul gaseous exhaust. On the other hand, if foods are properly combined for consumption, then regardless of how many calories or how much cholesterol they contain they will not make you fat or clog up your veins and organs, especially if at least half your daily food intake is taken raw. If one follows the rules of Trophology, there is no need to be a fanatic about controlling one's diet, no need to count calories, and no need to worry about cholesterol. Note also that there is no such thing as a food that is 100 percent protein Trophology introduction "Compared to Taoist concepts of balance, the Western notion of a 'balanced diet' is simplistic and superficial. Western physicians advise everyone to take 'a little of everything at every meal', jumbling together such disparate ingredients as meat, milk, starch, fat and sugar. Such indiscriminate consumption of food is no different than pouring a combination of gas, oil, alcohol and sugar into the gas tank of your car. These blends will not burn efficiently, will provide little power and will quickly clog up the engine so badly that the entire system grinds to a halt. The following advice given to the founding Emperor of the Ming Dynasty on the occasion of the authors 100th birthday, clearly reflects the fact that the ancient Chinese were well aware of the importance of the science of food combining. 'Food and drink are relied upon to nurture life. But if one does not know that the nature of substances may be opposed to each other, and one consumes them altogether indiscriminately, the vital organs will be thrown out of harmony and disastrous consequences will soon arise. Therefore, those who wish to nurture their lives must carefully avoid doing such damage to themselves.' [Chia Ming, Essential Knowledge for Eating and Drinking, 1368 AD]. In plain English, the Yin and Yang of diet boils down to 'Trophology', a term which you and no doubt your doctor, have probably never heard before. Modern medical training in the West, especially in America, is notoriously deficient in nutritional science, although there are a few enlightened nutritional scientists in America and Europe today who, despite sneers from their peers in the medical establishment, are making great medical strides through the science of Trophology. The Western scientific equivalent of Yin/Yang balance in food combinations is something we all learned in elementary high school chemistry: acid/alkaline balance, or 'pH'. We all know that if we did add a measure of alkaline to an equal measure of acid, the resulting chemical solution is as neutral as plain water. That's the principle behind reaching for bicarbonate (a strong alkaline) to relieve 'acid indigestion'. It is an established scientific fact in Western medicine that, in order to initiate efficient digestion of any concentrated animal protein, the stomach must secrete pepsin. But it is also a well-known fact that pepsin can function only in a highly acidic medium, which must be maintained for several hours for complete digestion of proteins. It is equally a well established fact of science that when we chew a piece of bread or potato or any other carbohydrate/starch, ptyalin and other alkaline juices are immediately secreted into the food by saliva in the mouth. When swallowed, the alkalized starches require an alkaline medium in the stomach in order to complete their digestion. Anyone should be able to figure out what therefore happens when you ingest protein and starch together. Acid and alkaline juices are secreted simultaneously in response to the incoming protein and starch, promptly neutralizing one another and leaving a weak, watery solution in the stomach that digests neither protein nor starch properly. Instead, the proteins putrefy and the starches ferment owning to the constant presence of bacteria in the digestive tract. This putrefaction and fermentation are the primary cause of all sorts of digestive distress, including gas, heartburn, cramps, bloating, constipation, foul stools, bleeding, piles, colitis, and so forth. Many so-called 'allergies' are also the direct result of improper food combinations: the bloodstream picks up the toxins from the putrefied, fermented mess as it passes slowly through the intestines, and these toxins in turn cause rashes, hives, headaches, nausea, and other symptoms commonly branded as 'allergies'. The same foods that cause allergic reactions when improperly combined often have no ill-side effects whatsoever when consumed according to the rules of Trophology. The final fact of the matter is this: when you immobilize your stomach and impair digestive functions by consuming foods in indiscriminate combinations, the bacteria in your alimentary canal have a field day. They get all the nutrients and thrive, while you get all the wastes and suffer." Source: Daniel Reid.